Report (2) V
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, �f , am the general contractor or the owner-builder
at the fo lowing address:
Site Address: /1_1/_ / -)k) 1 b
OL
City: - I ��
Permit#: nn - 6,
Subdivision/Lot#:
and/or lP J
Map and Tax Lot#:
To conform with the 2008 Oregon Residential Specialty Code(ORSC), Section R318.2 and
OAR 918-480-0140, I am notifying the building official that I am aware of the moisture content
Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement.
[Section R318.2 is provided for reference].
R318.2 Moisture Content: Prior to the installation of interior finishes, the building
official shall be notified in writing by the general contractor that all moisture-sensitive
wood framing members used in construction have a moisture content of not more than 19
percent by dry weight of dry framing members.
Signature: Date: �h-2.---
Ge - ;P:‹tractor o 4 weer-Builder
1:\Building\F'orm1RES-MoisturesensitiveWood.doc 09/25/08
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, ,,414/L St-a-e-
, am the general contractor or the owner-builder
at the following address:
Site Address: /,�/3g 9.,J / " 4,. ,
City: rr_licel
�k
Permit#: R4$T 00 Z/ - 6
Subdivision/Lot#: ( 7ii ,-e_ _ �le"
and/or
Map and Tax Lot#:
To conform with the 2014 Oregon Residential Specialty Code(ORSC), Section R408.1
Ventilation. I am notifying the building official that I have installed the Moisture Barrier as per
Requirement in ORSC Section 408.1 and have taken the following steps to meet this code
requirement:
The ground surface of the under-floor space is covered with 6-mil black polyethylene
sheetingyith
Joint lapped 12"at seams and
Extending up the foundation walls 12".
Signature: -�7ss.. Date: 3/30/2.-
-- �
ene . 'o:1 "'rS _. r-Builder
L•13uilding\Form\RES-MoistureBamer.doc 09/13/2016
V ^
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: di 90, _ ayg/ Jurisdiction: / C , , _/
Site Address: J l l3g 5 mil/, 1
Subdivision/Lot#: //„
vise_
and/or G�!'
Map and Tax Lot#:
By my signature below, I certify that a minimum of fifty(50)percent of the permanently
installed lighting fixtures in the above mentioned building have been installed with compact or
linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt.
(Oregon Residential Specialty Code N1107.2)t
Signature: _ ���_ Date: ` l 36/ZZ
• er/Gen-r. ontractorI thorized Agent
Print Name: , i 514°
✓
-04
ORSC Section N1107.2.High-efficiency interior lighting systems. A minimum of fifty(50)percent o the
permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that
has a minimum efficacy of 40 lumens per input watt. Screw-in compact fluorescent lamps comply with this
requirement.
The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the
permanently installed lighting fixtures are compact or linear fluorescent,or a minimum efficacy of 40 lumens per
input watt.
C\Building\Forms\RE.S-H,ighEfficiencyLighting.doc 07/01/08
•
1 10 (t ft
Form 640E 2017
Completion Certification—Site Inspection °�,T°ruSt
New HORNS Program—Single Family f
of Oregon
To be completed by Verifier
CLEAResult Is a Program Management Contractor for Energy Trust of Oregon,Inc.
Payment Information
Incentive Payee Company Name: 'Polygon Northwest-WA Its this payment redirected?: 'No
Builder or Company: Polygon Northwest-WA Redirect to Name:
Verifier Payee Company Name: Performance Insulation and Energy Redirect Payee Corn
Affordable Housing No
Solar Ready Builder Incentive: No 'Solar ReadyVerifier lnc4No
Site letformatlon
Development: R 14 EAS I RIDGE II MED 'Lot I166A Axis ID: IREM/Rate®ID:
Address. 14160 SW 165TH AVE
Street Line 2 MUIG-Famiry INo City: TIGARD Stale: OREGOA Zip: 97224
Total conditioned area(sq.ft.): 2,572 House Volume: I 22,965 Housing Type: Townhouse end
Number of Stories: 12 Number of Bedrooms: 5 Foundation Type: Crawlspace
Electric Provider: POrtNrid General Electric Gas Provider: NW Natural Gas
Solar installed None Solar Installer Name/Company:
Blue shaded fields are required for EPS sheet
Verification Typo Actual Model Equipment Details&Notes
Slab Perimeter Insulation R- Slab Under Insulation R-
Insulation Framed Floor R- 30.0 Secondary Framed Floor R- 59.0
Above Grade Wall Insulation R- 23.0 Below Grade Wall Insulation R-
Flat Ceiling Insulation R- 49.0 Vaulted Ceiling Insulation R-
windows Windows U- 0.3 SHGC:I0.3 Total window area:
Cooling Air Conditioning SEER: 0 Model it: 13ACXN030.230-26
Primary Heating System Details AFUE: 95 Brand Lennox
Type: Gas Furnace HSPF: Model#: ML196UHO70XE36B-52
Heating Fuel: Gas SEER'.
Primary Heal
Source Comment: COP:
Location: Attic Outdoor Unit(for heat pumps)
ECM: No Model it I
AHRI Certificate:4805339 of Systems Ii
Gallons: 165 Brand: BradfordWhite
Wafer Heater Type Storage EF: 13.4 Model if RE25016-1NCWW
Water Heating Fuel Electric Location: 'Garage�o`r�ape AHRI Certificate:9952297
Ducts and Duct Location 'Partial %ducts inside. prow _IDcct Leakage(GEM)(a]50Pa: 1139
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa. 3.39 1
Ventilation Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untesta hie? 'Roof Termination
Appliances
Refrigerator vAr/yr Model:
ENERGY STAR Diswasher kWNyr Model: GDFSIDPSRSSS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I Showerwand 1.5 GPH I Showerhead 1.6 GPH I IShewerhead 1.75 GPH I
Notes: